Program

Kaiser Kids Sun Care Program

The Kaiser Kids Sun Care Program was designed to increase
skin cancer prevention strategies among parents of young children. The
intervention relies on health care providers to educate parents and provide
them with informational materials at well-child visits. In a random assignment
study involving 14 offices in a large managed care organization, parents whose
children received care from practitioners assigned to the intervention engaged
in significantly more sun protection practices than did parents whose children
received care from practitioners uninvolved with the intervention. Skin
exams during the third summer of the intervention did not reveal significant
differences between children on measures of tanning, freckling, or number of
nevi, however.

DESCRIPTION OF PROGRAM

Target population: parents of children aged 0-3

In early childhood, well-child visits are recommended at 2,
4, 6, 9, 12, 18, 24, and 36 months of age. These visits are focused not
on treating illnesses, but instead on providing parents with “anticipatory
guidance” – education on optimum child development and health.

In an attempt to increase skin cancer prevention strategies
among parents of young children, the Kaiser Kids Sun Care Program was developed
to supplement well-child visits with information on sun protection.
Health care providers were given anticipatory guidance prompts to share with
parents at each visit. They were also given packets to deliver to parents
at each visit. These packets included sunscreen samples as well as
age-appropriate sun protection tips. Other giveaways to parents included
sun hats, brochures from the Skin Cancer Foundation, a refrigerator magnet,
UV-protective sunglasses, and suggested parent-child activities to teach about
the importance of sun protection.

Evaluated population: 728 infants from 14 health care
offices of the Denver/Bolder area of Colorado
served as the study sample for this investigation. These children were
recruited one to six months after birth via appeals to parents insured by Kaiser
Permanente of Colorado.
Over 80% of the children were white.

Approach: The 14 Denver/Bolder offices of Kaiser
Permanente were matched into pairs and then randomly assigned to the treatment
group or the control group. Study participants were assigned to the study
group of their local office.

Health care providers at the seven treatment group offices
were invited to attend meetings about the project. At well-child visits,
these providers gave parents anticipatory guidance alerts on sun protection and
distributed sun protection packets to parents. Health care providers from
control group offices were also familiarized with the project. These
providers gave usual care at well-child visits, which included discussing the
use of sunscreen with parents.

When parents entered the study, they were interviewed on
their usual sun protection practices. Parents were re-interviewed each
summer for three years. During the third summer, skin examinations were
offered to all children involved in the study; 38% of children took part in
these examinations.

Results: During the first summer of the intervention,
parents attending treatment group offices had only slightly higher average sun
protection scores than parents attending control group offices. Over
time, use of sun protection strategies by both groups of parents
declined. This decline was sharper among parents from control group
offices, and, at the third follow-up, treatment group parents were significantly
more likely than control group parents to score above the midpoint on the sun
protection scale.

Sunscreen use was high for both groups of parents and there
were no significant differences between the groups on sunscreen
practices. No differences emerged between the groups on sun avoidance or
clothing use. Parents from treatment group offices were more likely to
seek out shade for their children to play in than were parents from control
group offices.

Skin examinations at year three revealed no significant
differences between treatment and control children on mean exposed skin color,
tanning, freckling, or number of moles. Researchers were disappointed
that such a low proportion of children took part in skin examinations.
They caution against drawing too much from the results of these examinations,
as mole development can be a lengthy process.